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A World Without Daily Insulin

For people suffering from Type 1 diabetes, also known as juvenile diabetes, imagining a world without daily insulin injections is hard to do. For Dr. Alex Rabinovitch, it’s a world he not only imagines but believes is possible.

Dr. Rabinovitch is Senior Scientist and Associate Director of The Sanford Project to cure Type 1 diabetes. He and his team are currently conducting a clinical trial of two hormones that have proven to cure Type 1 diabetes in mice.

“Both of the drugs used to cure the mice are currently used in people for other medical conditions,” says Dr. Ravinovitch. “We found in our research that we could cure the mice’s diabetes with a combination of two drugs that raise the body’s levels of two hormones , one produced in the stomach and the other in the intestines during digestion.”

Goal to Find a Cure

The Sanford Project began in 2008 when philanthropist T. Denny Sanford gifted Sanford Health with the funding and the challenge to find a cure for Type 1 diabetes. Dr. Rabinovitch joined Sanford Health in 2009 after an internationally acclaimed research career in both Type 1 and Type 2 Diabetes in Canada, Switzerland, Denmark, and Florida.

Typically, Type 1 diabetes is diagnosed during childhood, adolescence or early adulthood. It occurs when the body’s pancreas stops producing insulin – a hormone needed to process blood sugar. Every person with Type 1 diabetes must take daily insulin as well as perform blood checks, regulate their diet and exercise. Insulin though has not always proven to be entirely effective in controlling blood sugar.

In Dr. Rabinovitch’s research, he’s learned that if the body can be convinced to regenerate Beta cells, it may be able to restore its ability to generate insulin. Beta cells in the pancreas are responsible for producing insulin. Finding a way to reactivate this process is key to the selection of the hormones being used in the clinical trial.

“Gastin and Glucagon-like peptide – 1 (GLP-1) are the two hormones that when raised in mice, regenerated new beta cells from other cells in the pancreas. It also stopped the autoimmune process that would have destroyed the new beta cells,” Dr. Rabinovitch says. The two drugs being used in the trial are Sitagliptin and Lansoprazole.

The Clinical Trial

The clinical trial began about six months ago and is set to enroll 54 patients who have recently been diagnosed with Type 1 diabetes. So far 28 patients have been selected.

Patients and their treating physicians will not know whether they are receiving the trial medicine or a placebo. Patients will take 2 capsules a day, along with insulin, for one year. At the end of the study, patients will be taken off therapy for one year to see if the hoped-for effect of improving pancreatic beta cell function and insulin secretion is achieved.

Presently, patients may receive clinical trial care at Sanford Sioux Falls, Sanford Fargo, the Minnesota Children’s Hospital & Clinics in Minneapolis and at the Rady Children’s Hospital in San Diego.

“If the outcome is positive – meaning patients will need less insulin and have improved glucose control – then we will conduct a much larger study. In addition to this research, we are also developing trials that will test other treatments that may become cures for type 1 diabetes,” says Dr. Rabinovitch.

Looking Forward

“The ultimate question of ‘when’ we will ‘cure diabetes’ is one that I am asked often by the families of our patients with type 1 diabetes,” says Dr. Rabinovitch. “The answer is we don’t know at present. If you ask me again a year from now, I hope to be able to tell you that we are beginning to see a positive effect in our first clinical trial, and that we can then improve this therapy or develop others in our goal to cure type 1 diabetes,”

The current type 1 diabetes clinical trial (REPAIR-T1D) is supported by the Juvenile Diabetes Research Foundation, Sanford Health and the Sanford Research/University of South Dakota in Sioux Falls. It is the first clinical trial in a series of trials that The Sanford Project is planning in its mission to cure this disease. To learn more about the clinical trial including eligibility requirements, please visit www.clinicaltrials.gov and search for REPAIR-T1D or NCT01155284.